MÉDECINS Sans Frontières (MSF), the global association of humanitarian doctors, has urged government to switch over to the viral load monitoring method instead of relying on the commonly-used CD4 count system on HIV and Aids patients saying the latest technology was more accurate in detecting HIV-related problems.
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MSF head of mission in Zimbabwe, Fasil Tezera in a statement yesterday said viral load monitoring system was more spot–on in problem detection.
“Viral load is much more accurate at detecting problems than CD4 testing, which is commonly used today, and it can also prevent people from being unnecessarily switched to more expensive ‘second-line’ medicines,” Tezera said.
He expressed concern at the way patients were being switched to more expensive second line medicines which most developing countries did not have in stock, thereby compromising their health.
MSF said the Global Fund to Fight Aids, Tuberculosis and Malaria and the United States President’s Emergency Plan for Aids Relief (Pepfar) programme — the two main funders of global HIV treatment — should promptly use their large purchasing power to negotiate for lower prices for viral load tests.
Of those suspected of treatment failure after standard HIV tests such as white cell counts and clinical signs, as many as 70% could be unnecessarily switched to more toxic treatments because these tests can falsely suggest their first-line treatment was failing.
A 2012 MSF survey of 23 resource-limited countries showed that only four used viral load monitoring in their treatment guidelines although all the countries had the guidelines in their programmes. The study looked at the first-ever viral load test among adults on antiretroviral therapy in Zimbabwe, Kenya and Malawi.
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“The latest World Health Organisation HIV treatment guidelines call for people to receive a viral load test once a year to ensure their treatment is working, and to identify those people who are either failing treatment, and must be switched to different drugs, or need extra adherence support to get back on track,” Tezera said.
With about 15% of the population living with HIV1, Zimbabwe is experiencing one of the harshest HIV and Aids epidemics in the world, but of late there has been a marked decrease in the prevalence with stakeholders attributing the decline to massive interventions by government and non-governmental organisations.
Prevention schemes have been significantly expanded since the turn of the millennium, but remain critically under-funded.
Although mortality rates have played a large part in reducing the number of people living with HIV among the population of Zimbabwe, it is believed prevention programmes aimed at behaviour change and the prevention of mother to child transmission have also been instrumental in bringing about a decline in HIV prevalence.
